the largest quantities come from india, china and canada. while these ingredients are produced in fact reas overseas that are approved by the f.d.a. , they rarely get inspected by federal regulators. allan coukell , a pharmacist and director of the medical safety program at the pew health group says in the last decade, the number of plants in india and china making ingredients for the american market has doubled at a time when f.d.a. has fewer resources to inspect them. >> if you're manufacturing overseas, you might never see an inspector after the initial inspection at the beginning of your manufacturing process. when inspections do go on overseas, they tend to be much short than domestic inspections. they're generally preannounced-- meaning the manufacturer has time to prepare ,-- and if problems are identified, the agency is much less able to go back subsequently and follow up to see whether the problems were adequately corrected. >> reporter: in 2008, 81 people died in the u.s. after being given the blood thinner heparin. ingredients for